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PE�MIT APPLICATION�'� <br />C17Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX n25-257-8857 <br />SITE ADDqESS <br />¢8/3 B�E� <br />LE�A' LOTNO. <br />DESC. � <br />� R� <br />(/� <br />BLOCK <br />�' / <br />PARCEL TAX I.�. M <br />� <br />l�T�'^"'-` ✓ �'11A..� <br />� X /Jan�r <br />N <br />O�j - �,�>�� <br />�LJ -L�'�66/ <br />TENANT NAME CCNTACT FOR PERMIT 'Jj' j( � PHONE ,�75 <br />-- /�//A I✓�t 7la�irws s�; u.s+. pr'lai �9 - a<< / <br />CONTRACTOR /_/]C�/ <br />(�vvr . <br />PHONE LlZ���/^I.S��(CF�i% <br />7 <br />ADDRESS <br />io�z7 3s�' qti6 ss <br />E�IT� l.u� . y�82a8 <br />ZIP CONTR. LICENSE M <br />G�&N�t w �S�- <br />PROPOSED USE OF BUILDING Building Mochenicol Addlllon HEAT SOURCE <br />�/� k�""�a��� PEFIdIT Combinntion R�.( Plumbing WORK Alterellan Q Electdc <br />/ TVPE Damolition u Sign TVPE � Now u Gas <br />S�� Sprinklor Repelr/Maint. U Othor <br />CONTRACT PRICE OF WORK � CITY OF EVERtTT LOCAL SALES TAX CODE IS 3105 <br />W!Iqi( DESC%�IPTION Gp�ST�VGirON pc �-f�N6Gv FA.t�I/��Q(;,S'fQ�/G� <br />�fiMP�� O� �t�lA�lN FZoO,e G!r//N6 AZvrj4� = Z� GG/ � <br />UN�NIs/ft� 6�RSL�;,!l�JT = � GQ,3-('F <br />��,aG� = f�l.�sF a�/Da,7N- e� = 47o sp Cal2�a /o�= �3o S� <br />PLUMBING i MECIIANICAL <br />NO. � TVPE OF FI%TURE OR ITEM <br />WATER CLOSET <br />BATHTUB <br />UIVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK B DISPOSAL <br />DISHWASHER <br />LAUNDRYTFAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />�ACKFLOW PR� �NT"ER <br />SINK (S[RVICEll7nil/ynOPiETC.) <br />nruo❑ �r <br />NO. � TYPE OF FIXTURE OR ITEM <br />.1_ A/C-A/HANDLINGUNITS <br />� FORCED AIR SYSTEMS <br />_ HEATPUMP <br />UNIT I I[ATERS <br />CLOTHES DRYER <br />FANaEH00D <br />_ WATEF� HEATER -- �N � �1'� <br />_ METAL FIREPUICE/STOVE <br />FIREPLACEINS[RT <br />a� GAS FIREPUICE <br />�GAS RANGE <br />GA� PIPING <br />�EXHAUSTFAN <br />OfHER __ <br />I HEREBY CERIiIFY THAT I HAVE READ AND E%A1dINED THIS APPLICATION AND KNOW THE SAh1E fiU BE TFUE AND CORRECT. ALL <br />PFOVISIONS OF LAWS AND ORIDINACES (iOVEIiNING TI115 NPE OF WORK WILL �E COMPLIED WITH WHE�HER uPECIFIED HEREIN OR <br />PJCT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE AUTHOFIN TO VIOLATE OR CANCEL THE PROVISION OF ANV OTHER <br />STATE OR LOCAL LAW REGULATING CONSIRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORI2EC BY T'HE <br />OWNE(i OF THIS PfiOPFRTv TO PERFORM THE 140RK FUR WHICH APPLICATION IS MADE AND I COMPIY WITH THE STATE <br />CONTRAC70RS LAW 18.27 RCN/ A 200 WAC. <br />����,��-- 9 -�-os�. <br />DEDIT & CREDIT CARDS ARE NOT ACCEPTED <br />�(a <br />